Duplicate Salt Sample Collection

Salt Sources Study

Documents and Forms

Document Name Document Type
Duplicate Salt Sample Collection Form
Bag Label Salt Added at the Table Att 13A1_Bag Label Salt Added at the Table_01082014.doc Form
Bag Label Salt Added in Food Prep Att 14A1_Bag Label Salt Added in Food Preparation_01082014.doc Form
Att 13B_Dup Salt Sample Instr (Non Sub Study)_01082014.doc Att 13B_Dup Salt Sample Instr (Non Sub Study)_01082014 IC Document
Att 13C_Dup Salt Sample Collection Instr (non Sub Study)_01082014.docx Att 13C_Dup Salt Sample Collection Instr (non Sub Study)_01082014 IC Document
Att 14B_Dup Salt Sample Collection Instr (Sub Study)_01082014.doc Att 14B_Dup Salt Sample Collection Instr (Sub Study)_01082014 IC Document

Information Collection (IC) Details

IC Title:	Duplicate Salt Sample Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Bag Label Salt Added at the Table	Att 13A1_Bag Label Salt Added at the Table_01082014.doc		No	No	Paper Only
Form	none	Bag Label Salt Added in Food Prep	Att 14A1_Bag Label Salt Added in Food Preparation_01082014.doc		Yes	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 252

Number of Respondents: 225	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att 13B_Dup Salt Sample Instr (Non Sub Study)_01082014	Att 13B_Dup Salt Sample Instr (Non Sub Study)_01082014.doc	01/09/2014
Att 13C_Dup Salt Sample Collection Instr (non Sub Study)_01082014	Att 13C_Dup Salt Sample Collection Instr (non Sub Study)_01082014.docx	01/09/2014
Att 14B_Dup Salt Sample Collection Instr (Sub Study)_01082014	Att 14B_Dup Salt Sample Collection Instr (Sub Study)_01082014.doc	01/09/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.